Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | D9781 | TX |
NPI | 1043635816 |
---|---|
Provider Name | Eduardo Manuel Diaz |
First Address | Houston, TX 77024-2672 |
Second Address | Houston, TX 77024-2672 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2014 |
Last Update Date | 03/03/2014 |